Physician Compliance Auditor
The Physician Compliance Auditor performs audits and evaluates compliance-related activities and services. Auditing may include documentation and coding of Evaluation/Management (E/M) services, procedures, midlevel services, and Teaching Physician and resident services. Utilizes ICD-9, CPT, HCPCS and other coding references to ensure accurate coding has been performed by physicians and clinic staff.
§ Performs annual chart audits and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel; prepares and submits compliance reports to the compliance committee.
§ Implements annual coding reviews, create work plans based on the reviews and ensure that compliance issues and areas of risk are identified and addressed
§ Assists in curriculum development to be used in orienting and educating physicians and staff to medical record documentation guidelines and standards and to diagnostic and procedural coding conventions and methodologies; provides feedback and education sessions to providers and staff regarding coding and billing issues in a clear, concise and professional manner as required
§ Serves as a Coding compliance resource and consultant for all physician and mid-level providers, company administrators, and physician practice staff; assists in developing policies and procedures on coding compliance for clinics and the compliance department.
§ Fulfills continuing education and/or certification requirements to maintain required qualifications and/or knowledge; remains current with compliance, coding, and billing regulatory trends and innovations by participating in external professional associations and seminars as needed, and attend continuing education classes
§ Participates in mentoring activities and classes provided by Baylor Scott & White Health
§ Must be able to travel at least 25% of the time
The ideal candidate for the Physician Compliance Auditor role is highly adept and experienced as an Auditor, preferably in cardiology procedure and/or interventional cardiology coding as well as E/M auditing and must have working knowledge of electronic health records. The ideal candidate will also demonstrate professionalism, strong oral & written communication, strong analytical aptitude and presentation skills. Experience managing multiple projects and tight deadlines is also preferred.
§ Location/Facility – Dallas Texas
§ Specialty/Department/Practice – Compliance
§ Shift/Schedule – M-F 8-5 pm
§ Benefits – Our competitive benefits package includes*:
ü Immediate eligibility for health and welfare benefits
ü 401(k) savings plan with dollar-for-dollar match up to 5%
ü Tuition Reimbursement
ü PTO accrual beginning Day 1
*Note: Benefits may vary based upon position type and/or level.
§ Associate’s Degree required
o Bachelor’s Degree in Health Science-related field (e.g. BA, BS or BSN) is preferred
§ Certified Professional Coder (CPC) or CPC-P required
§ 3+ years of experience required
o Audit experience preferred
HTPN - Compliance
HTPN - Compliance (10400)
8080 N Central Expy